Physical restraints are commonly used in intensive care units to reduce the risk of injury and ensure patient safety. However, there is still controversy regarding the practice of physical restraints in such units. The purpose of this study was to investigate the practices of physical restraints among critical care nurses in El-Mansoura City, Egypt. The study involved a convenience sample of 275 critically ill adult patients, and 153 nurses. Data were collected from 11 intensive care units using a "physical restraint observation form" and a "structured questionnaire." The results revealed that physical restraint was commonly used to ensure patient safety. Assessment of physical restraint was mainly restricted to peripheral circulation. The most commonly reported physically restrained site complications included: redness, bruising, swelling, and edema. The results illustrated a lack of documentation on physical restraint and a lack of education of patients and their families about the rationale of physical restraint usage. The study shed light on the need for standard guidelines and policies for physical restraint practices in Egyptian intensive care units.

Aim:To investigate critical care nurses' perceptions of barriers and supportive behaviors in providing end of life (EOL) care to dying patients and their families. Methods:The study involved a convenient sample of 70 nurses who were involved in caring for critically ill patients. Data were collected using a structured interview sheet. Results:Barriers to providing EOL care were related to intensive care environment, family members, nurses' knowledge and skills, physicians' attitudes and treatment policy. Possible help to providing EOL care involved nurses' support to each other, patient and family-centered care, and families' support. Conclusions:There is a need to allow the family unlimited access to the dying patient, involve them in patient care and provide them with a private place for grieving.

Background: Patients in the critical care unit (CCU) are, by definition, the sickest patients in acute care hospitals and face higher risk of death than any other hospital population and usually require advanced life support such as mechanical ventilation, inotropes, or dialysis. Since every day critical care nurses encounter death and dying in the critical care units, Nurses are vital to end-of-life care as they are the ones present at the bedside, they have an opportunity to observe behaviours and actions that are barriers to a peaceful and dignified death while they provide end-of-life care. Do-notresuscitate orders (DNR) are used in many countries to limit the use of cardiopulmonary resuscitation (CPR) in certain situations. There is still a continuing debate about the ethics, legalities and the appropriate medical indications for use of DNR. The status of DNR can raise many issues for nurses, including ethical dilemmas, conflict, and power struggles among members of the health care team.

Background: The adolescent developmental stage has been described by researchers as a period in which decision-making abilities and independence skills are developed; therefore, this period may attract more attention from health-care providers as a key time for establishing healthy life styles and positive adaptive behaviours, such as nutritional behaviours. Methods: A quasi-experimental control group, and post-test only design was used. A school-based healthy nutrition educational programme was implemented to improve the nutritional knowledge of adolescents, and to promote a healthy life style among them. The ‘Let's Eat Healthy’ programme was delivered to 150 students in the intervention group, who were compared to another 150 students in the control group where the programme was not delivered. Results: Students that participated in the intervention group were significantly more knowledgeable about healthy nutrition compared to students that didn't participate (P<0.01). They also scored significantly higher in the dietary behaviours survey, which reflects the adoption of more healthy eating behaviours. Conclusions: The results of the study revealed that such a programme would be effective in promoting more nutritionally healthy life styles, thus preventing obesity and nutrition-related disease among adolescents in United Arab Emirates (UAE) schools.

Aim To determine the outcomes of Family‐centred Auditory and Tactile Stimulation Implementation on Traumatic Brain Injured Patients in Egypt. Background Family engagement in the care of their relatives in the Intensive care units is limited due to patients' life‐threatening conditions, in addition to the use of high technology in these settings. Auditory and tactile sensory stimulations are among the diverse sensory stimulations that have received more attention in brain injured patients than other senses as being considered safe, and effective measures. Design A Quasi‐experimental design was used to test the hypotheses of this study. Methods A convenience sample of 60 adult patients suffering from Traumatic Brain Injury and admitted to the intensive care units of two University Hospitals in Egypt was included in the study. Patients were assigned into two equal groups: control and study groups (30 patients each). The auditory and tactile stimulations were provided by trained family members, once daily for 2 weeks for the study group. Whereas routine communication was provided by the family of traumatic brain injured patients in the ICU for the control group. Two tools were used for data collection; tool one, the “Glasgow Coma Scale” to assess patient's level of consciousness, and tool two the “Physiological Adverse Events Assessment” to monitor patients for the occurrence of physiological adverse events. Data collection: January to October 2019. Results The implementation of an organized auditory and tactile stimulation by trained family members is associated with highly statistically significant positive effects . Patients in the study group showed a higher mean of consciousness, lower incidence rate of physiological adverse events, and a lower mean duration of ICU stay. Conclusions Implementation of an organized auditory and tactile stimulation by trained family members enhanced the consciousness level of comatose Traumatic Brain Injured patients, decreased the occurrence of physiological adverse events, and ICU length of stay. Thus, it is recommended for use in the daily routine nursing care of comatose Traumatic Brain Injured patients. Relevance to Clinical Practice This study gives a deeper understanding of how family engagement in the care of their critically ill relative enhances their recovery and improve their level of consciousness.